What COVID-19 vaccine is best for myeloma patients?

Transcript:

This week’s “Ask Dr. Durie” is a question from many patients who want to know: Which vaccine for COVID-19 should they take?  

Right now, there are six vaccines available, of which three are available in the United States. The three that are available in the United States are the Pfizer and the Moderna, and then there’s also what’s called a vector vaccine, with the spike protein, the J&J vaccine. Outside of the U.S., there’s AstraZeneca, and then also Sputnik V vaccine, all vector vaccines, and then the sixth vaccine is the Sinopharm, which is an activated virus vaccine which comes from China. The Sputnik V vaccine is also manufactured in China. 

For now, it’s strongly recommended that, if possible, patients try to receive either the Pfizer or the Moderna vaccines which have the highest efficacy benefit and have had the least indications of any toxicities. 

Unfortunately, we have seen some extra toxicities with the vector vaccines. The J&J and the AstraZeneca have both had indications of a rare risk of blood clot problems, particularly for younger women under the age of 50. 

The big picture is that if you have a chance to get vaccinated, you should, obviously, do it with due caution, go ahead and get whichever vaccine is available to you.  

We know that in the main areas of benefit which is hospitalization and the risk that you might die from a COVID-19 infection, all the vaccines do a fantastic job in that regard. 

The level of efficacy in terms of infection and spreading the infection, it’s a little bit less with the Sputnik V and the Sinopharm vaccines, for example.  

The additional point for myeloma patients is that we are waiting to see if a booster will be necessary and what type of booster might be required. It seems that in myeloma patients, the antibody response and the immune cell response is less than we might want to see. 

There quite probably will be a recommendation for additional booster shot, maybe later this year or maybe early next year. What will that look like? We need to wait and see. Will it be just to repeat the Pfizer or Moderna or will it be a new one those tailored to cover the new variants that have been popping up, particularly from Brazil and from the U.K., and here now, more recently possibly from India? 

For now, the BOTTOM LINE is go ahead and get vaccinated with whatever is available to you with a preference for the Pfizer or the Moderna and be alert of the possible need for a booster later this year or early next year.